Normalization of lipid metabolism after withdrawal from antihypertensive long-term therapy with beta blockers and diuretics.
Blood pressure and serum lipoprotein concentrations were assessed in 40 men with essential hypertension at the end of a long-term, controlled intervention study (HAPPHY) after 5.2 +/- 1.4 years of treatment with hydrochlorothiazide (n = 23) or atenolol (n = 17) and after a wash-out period. After withdrawal from antihypertensive medication, the blood pressures of patients treated with diuretics or beta blockers rose from 142/93 and 145/91 to 159/106 and 165/104 mm Hg, respectively. At the same time, low density lipoprotein cholesterol decreased by 17 and 12 mg/dl, respectively, in the diuretic and beta blocker groups (p less than 0.05). In addition, total cholesterol decreased by 16 mg/dl (p less than 0.05) in the diuretic group, whereas high density lipoprotein cholesterol increased by 8 mg/dl (p less than 0.01) and triglycerides decreased by 27 mg/dl (p less than 0.05) in the beta blocker group at the end of the wash-out period as compared to the final phase of the HAPPHY study. The data indicate the persistence of lipid changes during long-term treatment with hydrochlorothiazide and atenolol. For the first time, it was clearly demonstrated that the well-known unfavorable effects of diuretics and beta blockers on lipid metabolism are reversible after cessation of long-term therapy of several years' duration.
Middeke
M
M
Medical Policlinic, University of Munich, FRG.
Richter
W O
WO
Schwandt
P
P
Beck
B
B
Holzgreve
H
H
D000959:Antihypertensive Agents / Q000009:adverse effects*; D001262:Atenolol / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D050356:Lipid Metabolism; D008297:Male; D013997:Time Factors; D014280:Triglycerides / Q000378:metabolism
D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D006852:Hydrochlorothiazide; D001262:Atenolol